Dosimetric patterns of failure in the era of novel chemoradiotherapy in newly-diagnosed glioblastoma patients.

Glioblastoma Glioma Patterns of failure Recurrence

Journal

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
ISSN: 1879-0887
Titre abrégé: Radiother Oncol
Pays: Ireland
ID NLM: 8407192

Informations de publication

Date de publication:
Nov 2023
Historique:
received: 18 11 2022
revised: 09 06 2023
accepted: 21 06 2023
pubmed: 30 6 2023
medline: 30 6 2023
entrez: 29 6 2023
Statut: ppublish

Résumé

Patterns of failure (POF) may provide an alternative quantitative endpoint to overall survival for evaluation of novel chemoradiotherapy regimens with glioblastoma. POF of 109 newly-diagnosed glioblastoma patients per 2016 WHO classification who received conformal radiotherapy with concomitant and adjuvant temozolomide were reviewed. Seventy-five of those patients also received an investigational chemotherapy agent (everolimus, erlotinib, or vorinostat). Recurrence volumes were defined with MRI contrast enhancement. POF at protocol (POF POF of the temozolomide-only control cohort were unchanged (79% central, 12% non-central, and 9% both) across protocol, initial, and RANO progression timepoints. Unlike the temozolomide-only cohort, POF of the collective novel chemotherapy cohort appeared increasingly non-central when comparing POF POF of patients receiving a novel chemotherapy appeared to be influenced by the timepoint of analysis and were increasingly non-central at protocol progression as compared with initial recurrence, suggesting that recurrence originates from the central region. Addition of everolimus and vorinostat appeared to influence POF, despite similar survival outcomes with the temozolomide-only control group. In studies dealing with novel therapeutic agents, robust and properly-timed dosimetric POF analysis may be helpful to evaluate biologic aspects of novel agents.

Sections du résumé

BACKGROUND BACKGROUND
Patterns of failure (POF) may provide an alternative quantitative endpoint to overall survival for evaluation of novel chemoradiotherapy regimens with glioblastoma.
MATERIALS AND METHODS METHODS
POF of 109 newly-diagnosed glioblastoma patients per 2016 WHO classification who received conformal radiotherapy with concomitant and adjuvant temozolomide were reviewed. Seventy-five of those patients also received an investigational chemotherapy agent (everolimus, erlotinib, or vorinostat). Recurrence volumes were defined with MRI contrast enhancement. POF at protocol (POF
RESULTS RESULTS
POF of the temozolomide-only control cohort were unchanged (79% central, 12% non-central, and 9% both) across protocol, initial, and RANO progression timepoints. Unlike the temozolomide-only cohort, POF of the collective novel chemotherapy cohort appeared increasingly non-central when comparing POF
CONCLUSION CONCLUSIONS
POF of patients receiving a novel chemotherapy appeared to be influenced by the timepoint of analysis and were increasingly non-central at protocol progression as compared with initial recurrence, suggesting that recurrence originates from the central region. Addition of everolimus and vorinostat appeared to influence POF, despite similar survival outcomes with the temozolomide-only control group. In studies dealing with novel therapeutic agents, robust and properly-timed dosimetric POF analysis may be helpful to evaluate biologic aspects of novel agents.

Identifiants

pubmed: 37385378
pii: S0167-8140(23)00306-7
doi: 10.1016/j.radonc.2023.109768
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

109768

Informations de copyright

Copyright © 2023 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Maasa H Seaberg (MH)

University of California San Francisco Medical Center, Department of Radiation Oncology, San Francisco, CA, USA.

Tomas Kazda (T)

Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic.

Ryan S Youland (RS)

Minnesota Oncology, Saint Paul, MN, USA.

Nadia N Laack (NN)

Mayo Clinic, Department of Radiation Oncology, Rochester, MN, USA.

Deanna H Pafundi (DH)

Mayo Clinic, Department of Radiation Oncology, Jacksonville, FL, USA.

S Keith Anderson (SK)

Mayo Clinic, Health Sciences Research, Rochester, MN, USA.

Jann N Sarkaria (JN)

Mayo Clinic, Department of Radiation Oncology, Rochester, MN, USA.

Evanthia Galanis (E)

Mayo Clinic, Department of Oncology, Rochester, MN, USA.

Paul D Brown (PD)

Mayo Clinic, Department of Radiation Oncology, Rochester, MN, USA.

Debra H Brinkmann (DH)

Mayo Clinic, Department of Radiation Oncology, Rochester, MN, USA. Electronic address: brinkmann.debra@mayo.edu.

Classifications MeSH